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JACC Cardiovasc Interv. 2014 Jun;7(6):688-95. doi: 10.1016/j.jcin.2013.11.024. Epub 2014 May 14.

Lumen gain and restoration of pulsatility after implantation of a bioresorbable vascular scaffold in porcine coronary arteries.

Author information

1
Abbott Vascular, Santa Clara, California.
2
Abbott Vascular, Santa Clara, California. Electronic address: laura.perkins@av.abbott.com.
3
CVPath, Inc., Gaithersburg, Maryland.
4
American Preclinical Services, Minneapolis, Minnesota.

Abstract

OBJECTIVES:

Using intravascular ultrasound (IVUS) and histomorphometry, this study sought to evaluate the potential of nonatherosclerotic porcine coronary arteries to undergo progressive lumen gain and a return of pulsatility after implantation with an everolimus-eluting bioresorbable vascular scaffold (BVS).

BACKGROUND:

Unique benefits such as lumen gain and restored vasomotion have been demonstrated clinically after treatment with BVS; however, a more rigorous demonstration of these benefits with a randomized clinical trial has not yet been conducted.

METHODS:

Seventy nonatherosclerotic swine received 109 everolimus-eluting BVS and 70 everolimus-eluting metal stents randomized among the main coronary arteries. Arteries were evaluated in vivo by angiography and IVUS and post-mortem by histomorphometry at time points from 1 to 42 months.

RESULTS:

From 1 to 6 months, both BVS- and everolimus-eluting metal stent-implanted arteries demonstrated stable lumen areas (LAs). From 12 months to 42 months, there was a progressive increase in the LA of arteries implanted with a BVS as assessed by histomorphometry and IVUS. This lumen gain in the implanted segment corresponded to an increase in the reference vessel LA. Normalization in the in-segment LA (LA:reference vessel LA) was observed qualitatively by angiography and quantitatively by IVUS. Additionally, BVS-implanted arteries demonstrated restored in-segment pulsatility on the basis of IVUS assessment of the differences in the mid-scaffold area between end-diastole to end-systole.

CONCLUSIONS:

Starting at 12 months, BVS-implanted porcine coronary arteries underwent progressive lumen gain and showed restored pulsatility. These benefits demonstrated preclinically may translate into improvements in long-term clinical outcomes for patients treated with BVS compared with conventional drug-eluting stents.

KEYWORDS:

animals; bioresorbable scaffold; coronary artery imaging; pathology

PMID:
24835327
DOI:
10.1016/j.jcin.2013.11.024
[Indexed for MEDLINE]
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